340B Drug Pricing Program Database
WALGREEN CO.
CH053060 Sixteenth Street Community Health Centers, Inc. - information as of 4/30/2025 12:13:29 AM
Covered Entity Details
Entity Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers-Chavez
Type
HRSA-Funded Health Center
340B ID
CH053060
Entity Address
1032 S Cesar E Chavez Dr
MILWAUKEE, WI 53204
Grant Number
H80CS00593
Participating Start Date
10/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03578
2275 NORTH MAYFAIR ROAD
WAUWATOSA, WI 53226
Pharmacy Comments
Contract Details
Approval Date
10/19/2012
Contract Begin Date
10/19/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOHN BARTKOWSKI, CEO
(414) 672-6220
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/19/2012
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